phytonadione; vitamin K1; phylloquinone; phytomenadione; methylphytyl naphthoquinone (Mephyton, AquaMephyton)

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Introduction

Tradnames: Mephyton, AquaMephyton.

Indications

Dosage

  • 5-10 mg PO/IV/SC/IM BID PRN
  • recheck INR 6-8 hours after parenteral administration or 12-48 hours after oral administration
  • infants & children 1-2 mg every 4-8 hours IM/IV

Tabs: 5 mg.

Injection: 2 mg/mL (0.5 mL), 10 mg/mL (1 mL, 2.5 mL, 5 mL). .Recommended IV dosing to reverse coumadin excess (no bleeding)

  • INR < 6: omit 1-2 doses of coumadin & restart at lower dose when INR is therapeutic
  • INR = 6-10: vit K 0.5-1 mg slow IV/PO; may repeat in 24 hours if INR is still elevated; consider 2.5-5.0 mg orally#
  • INR 10-20: vit K 3-5 mg slow IV*; may repeat in 6-12 hours if INR is still elevated
  • INR > 20: vit K 10 mg slow IV*; may repeat in 12 hours if INR is still elevated

* vit K should be diluted & given not faster than 1 mg/min

# vit K 1.0 mg PO may be more appropriate[4] PO as effective as IV[5]

Injectable vitamin K can be given orally if < 5 mg dose[6]

Pharmacokinetics

elimination via liver

Adverse effects

Drug interactions

More general terms

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 Department of Veterans Affairs, VA National Formulary
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  4. 4.0 4.1 Journal Watch 22(19):150, 2002 Crowther MA et al, Ann Intern Med 137:251, 2002
  5. 5.0 5.1 Journal Watch 24(1):2, 2004 Lubetsky A et al Arch Intern Med 163:2469, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14609783
  6. 6.0 6.1 Prescriber's Letter 13(10): 2006 Alternative or 'Off-label' Routes of Drug Administration Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=221012&pb=PRL (subscription needed) http://www.prescribersletter.com
  7. 7.0 7.1 7.2 Deprecated Reference

Database